Mahmoud Randa K, El-Ansary Amina K, El-Eishi Hatem H, Kamal Haba M, El-Saeed Nehal H
The Departments of Medical Biochemistry, Rheumatology, Faculty of Medicine, Cairo University, Madinat Nasr, Egypt.
Ital J Biochem. 2005 Sep-Dec;54(3-4):248-57.
To investigate whether serum levels of matrix metalloproteinases (MMP-3, stromelysin) and (MMP-1, collagenase) are specifically elevated in joint disease as rheumatoid arthritis (RA) compared to osteoarthritis (OA), and to assess how these markers reflect the clinical activity of RA compared to circulating cytokine as tumor necrosis factor-alpha (TNF-alpha) as well as established variables as [C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)].
This study included 22 patients with RA, 10 patients with OA and 10 healthy control subjects matched for age and sex. Patients with superimposed infection were excluded. Serum levels of MMP-3, MMP-1, TNF-alpha and CRP were assayed. Synovial fluid (SF) levels of MMP-3 and MMP-1 were also assayed.
Serum levels of TNF-alpha and CRP in RA patients were significantly higher than normal subjects. Serum MMP-1 was significantly elevated in patients with RA and OA, compared to healthy controls but there were no significant differences between patients with RA and those with OA. Serum MMP-3 levels did not differ between OA patients and normal sera. However, RA patients displayed significantly elevated levels of this enzyme, compared to OA and control sera. Levels of MMP-3 and MMP-1 in the SF of RA patients were significantly higher than in OA fluids. CRP, ESR, TNF-alpha and MMP-3 correlated significantly with the swollen joint count. The strongest positive correlations existed between rheumatoid activity as assessed by the levels of CRP and circulating levels of MMP-3. Similar correlations between TNF-alpha concentration and CRP, MMP-1 and MMP-3 were observed in RA patients. Serum levels of MMP-3 correlated significantly with serum concentrations of MMP-1 in RA patients (r = 0.487, p < 0.05). There was close correlation between serum and SF concentrations of MMP-3 in RA patients (r = 0.619, p < 0.01). In the same patients there was highly significant correlation between SF concentrations of MMP-3 and MMP-1 (r = 0.732, p < 0.001).
Our data suggested that elevated MMP-3 levels reflected disease activity of RA better than cytokine levels. However, MMP-3 levels do not exceed the association of CRP with clinical activity.
研究与骨关节炎（OA）相比，类风湿关节炎（RA）等关节疾病患者血清中基质金属蛋白酶（MMP - 3，基质溶解素）和（MMP - 1，胶原酶）水平是否特异性升高，并评估与循环细胞因子肿瘤坏死因子-α（TNF -α）以及既定变量如C反应蛋白（CRP）和红细胞沉降率（ESR）相比，这些标志物如何反映RA的临床活动。
本研究纳入22例RA患者、10例OA患者以及10名年龄和性别匹配的健康对照者。排除合并感染的患者。检测血清中MMP - 3、MMP - 1、TNF -α和CRP水平。同时检测滑膜液（SF）中MMP - 3和MMP - 1水平。
RA患者血清中TNF -α和CRP水平显著高于正常受试者。与健康对照相比，RA和OA患者血清MMP - 1显著升高，但RA患者与OA患者之间无显著差异。OA患者血清MMP - 3水平与正常血清无差异。然而，与OA和对照血清相比，RA患者该酶水平显著升高。RA患者SF中MMP - 3和MMP - 1水平显著高于OA患者。CRP、ESR、TNF -α和MMP - 3与肿胀关节计数显著相关。CRP水平评估的类风湿活动与循环MMP - 3水平之间存在最强的正相关。在RA患者中观察到TNF -α浓度与CRP、MMP - 1和MMP - 3之间存在类似的相关性。RA患者血清MMP - 3水平与血清MMP - 1浓度显著相关（r = 0.487，p < 0.05）。RA患者血清和SF中MMP - 3浓度之间存在密切相关性（r = 0.619，p < 0.01）。在同一患者中，SF中MMP - 3和MMP - 1浓度之间存在高度显著相关性（r = 0.732，p < 0.001）。
我们的数据表明，MMP - 3水平升高比细胞因子水平更能反映RA的疾病活动。然而，MMP - 3水平与临床活动之间的关联未超过CRP。
